Most deaths from tumors in Brazil occur among people with low education and low income

More than half of deaths from tumors in Brazil (55%) occur among people with low education and low income, reveals a study by the Umane Primary Care Observatory, based on the latest survey by the Mortality Information System (SIM) of the Ministry of Health. Saúde de 2020. Umane is an independent, non-profit civil association, focused on articulating and promoting initiatives to support the development of the Unified Health System (SUS).

According to SIM data, of the 229,300 people who died from neoplasms (malignant or benign) in Brazil in 2020, 126,555 (55%) had studied for up to 7 years; 20% had between 8 and 11 years of schooling and 9.2% had between 12 years or more of schooling. Data show that mortality is higher among those with less education and income.

The majority (52%) of deaths from neoplasms (malignant or benign) are men and 48% are women, and 59.2% of victims are over 65 years of age.

The overall improvement in quality of life could prevent some of these cases, says the director of Communication at the Brazilian Society of Family and Community Medicine, Rafaela Alves Pacheco, who is a sanitary doctor and professor at the Federal University of Pernambuco.

“Cancers are multiple, but they have a very close relationship with the quality of life, the organization of cities, the preservation of biomes, food, emotional conditions, work and access to human rights, as well as with education, transport, quality of life and access to health. All these perspectives will bring us closer or further away from effective care in relation to cancers in general”

says Raphaela.

For the specialist, primary health care, family and community medicine can improve this situation. “It is necessary to guarantee comprehensive health care, prevention, promotion and access to [a tratamentos] in any cancer situation. So, it is to ensure the strengthening of health systems”, he recommends.

According to the doctor, cancer does not choose social class, but poor populations suffer more. “With regard to cancer, all social classes are affected, but there are the corners of poverty and misery. So, it is quite different for those who are poorer and do not have access and, therefore, end up having a higher incidence of cancer, in general.”

According to the expert, the solution is health equity actions. “You have to give more to those who need it more. If we have populations that are more vulnerable to cancers, they will need to be provided with differentiated resources and health and social measures. In this sense, strengthening the universal health system is strengthening primary care, with family health strategy teams that are closer to where people live and work.”

health promotion

In the sanitarian’s view, it is necessary to ensure that this public has a greater contribution to health promotion, as well as easy access to primary health care services. “From the perspective of health prevention, we need to have structured protocols, lines of care that will carry out early detection, evidence-based screening and clinical protocols, when they are really necessary and can reduce both morbidity and mortality, including ensuring palliative care, ensuring that the patient manages to have a survival and quality of life in the face of what is possible.”

Rafaela points out that not all of these dimensions are part of the work area of ​​primary health care. “They are at other levels of care, but they can and should be connected with primary health care, with the best for each of these situations.”

The doctor points out that there are public policies that aim to increase the access of the population with low education to information, but that the complexity of the problems requires intersectoral actions. “The problem is sanitary, but it is also environmental and social. So we are going to need many hands, and many sectors of organized civil society and public policies that are acting together”.

The doctor points out a series of factors that must occur together with care in education and health

“The Brazilian educational system itself can and should help, especially with children, adolescents and young adults, guaranteeing this knowledge, this self-monitoring, the improvement of their own schooling, which will also make access to education and health happen. in a more shared and impactful way. The guarantee of healthy eating, physical activity, the fight against smoking, the improvement of weight indices, from the perspective of obesity”, exemplifies Rafaela.

For her, food control and improvement also concern combating the use of pesticides and chemical additives and controlling air, water and forest pollution. “With respect for our biomes, the guarantee of public policies that induce access to healthy food, real food, which is not full of ultra-processed products, so that there is metabolic and well-being improvement. We need to decrease salt in food, in general. It’s not just the person’s salt shaker, there needs to be rules that ensure that the available options are in fact compatible with the health of a large part of the population.”

Rafaela recalls that Brazil has a large number of hypertensive and diabetic patients and that these are factors for the appearance of cancer and other illnesses. “Improving nutrition, it becomes less inflammatory and less cancerous”, she points out.

role of agents

Physician Gilberto Amorim, from Oncologia D’Or in Rio de Janeiro, emphasizes that many of the risk factors for different types of cancer can somehow be modified or reduced and that, for this, the health agent has a fundamental role.

“The population with low levels of education needs to know more about these risk factors and, there, the reach of health agents is greater than that of any other professional in the area. For example, obesity is a risk factor for many types of disease. Therefore, it is essential that the health agent warn that person about the risks for diabetes and vascular diseases and also for various cancers”, says the oncologist.

According to the oncologist, the basic health agent reaches this most disadvantaged population because he has a language that is easy to understand, less elaborate than that of doctors, and they manage to have an incredible capillarity throughout Brazil. “They can speak to many things and contribute to reducing the risk of certain types of cancer.”

Prevention measures for the most prevalent types of cancer in adults are, in general, related to the control of the main risk factors, such as smoking, excessive alcohol consumption, inadequate diet and obesity.